Multiple sampling in one day to optimize smear microscopy in children with tuberculosis in Yemen

Al-Aghbari, N., Al-Sonboli, N., Yassin, Mohammed A., Coulter, John B.S., Atef, Z., Al-Eryani, A. and Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 (2009) 'Multiple sampling in one day to optimize smear microscopy in children with tuberculosis in Yemen'. PLoS ONE, Vol 4, Issue 4, e5140.

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Abstract

Background and Aim

The diagnosis of pulmonary Tuberculosis (TB) in children is difficult and often requires hospitalization. We explored whether the yield of specimens collected for smear microscopy from different anatomical sites in one visit is comparable to the yield of specimens collected from a single anatomical site over several days.

Methodology and Principal Findings

Children with signs/symptoms of pulmonary TB attending a reference hospital in Sana'a Yemen underwent one nasopharyngeal aspirate (NPA) the first day of consultation and three gastric aspirates (GA) plus three expectorated/induced sputa over 3 consecutive days. Specimens were examined using smear microscopy (Ziehl-Neelsen) and cultured in solid media (Ogawa). Two hundred and thirteen children (aged 2 months-15 years) were enrolled. One hundred and ninety seven (93%) underwent nasopharyngeal aspirates, 196 (92%) GA, 122 (57%) expectorated sputum and 88 induced sputum. A total 1309 specimens were collected requiring 237 hospitalization days. In total, 29 (13.6%) children were confirmed by culture and 18 (8.5%) by smear microscopy. The NPA identified 10 of the 18 smear-positives; three consecutive GA identified 10 and induced/expectorated sputa identified 13 (6 by induced, 8 by expectorated sputum and one positive by both). In comparison, 22 (3.7%) of 602 specimens obtained the first day were smear-positive and identified 14 (6.6%) smear-positive children.

Conclusion/Significance

The examination of multiple tests the first day of consultation identified a similar proportion of smear-positive children than specimens collected over several days; would require half the number of tests and significantly less hospitalization. Optimized smear microscopy approaches for children should be explored further.

Item Type:	Article
Subjects:	WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General) WS Pediatrics > By Age Groups > WS 450 Puberty QY Clinical Pathology > Diagnostic Tests > QY 120 Sputum WF Respiratory System > Tuberculosis > WF 220 Diagnosis. Prognosis WF Respiratory System > Tuberculosis > WF 205.1 General coverage WS Pediatrics > By Age Groups > WS 430 Infancy WB Practice of Medicine > Medical Climatology > WB 710 Diseases of geographic areas WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WF Respiratory System > Tuberculosis > WF 415 Tuberculosis in childhood WF Respiratory System > Tuberculosis > WF 205 Epidemiology WS Pediatrics > By Age Groups > WS 440 Preschool child WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1371/journal.pone.0005140
Depositing User:	Pauline Anderson
Date Deposited:	10 Mar 2010 14:26
Last Modified:	17 Jul 2020 10:57
URI:	https://archive.lstmed.ac.uk/id/eprint/214

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